new meal pattern implementation training...infant meal pattern •meals are reimbursable when a...

New Meal Pattern Implementation Training

June/July 2017

Ground Rules

• Be a team player

• Be respectful of everyone

• Please, no side conversations – they are disruptive to everyone

• Turn your mind on & electronic devices to silent or off

• Keep questions for the end of each segment – index cards are on tables for you to write them down as we go

Purpose of the Update

• Align the CACFP meal pattern with the Dietary Guidelines for Americans (DGA)

• Address the current health status of children & adults

• Enhance the nutritional quality of meals & snacks

• Help children develop healthy eating habits

CACFP Operators/Providers must implement updated meal pattern requirements by

October 1, 2017

Infant Meal Pattern Requirements

Infant Meal Pattern • Meals are reimbursable when a mother

breastfeeds on-site

• Features two age groups: Birth – 5 months and

6 – 11 months

• Provides more nutritious meals and snacks Vegetables & fruits must be served at snack for older age

group

Juice, cheese food, or cheese spread are no longer credible

Yogurt, cheese, cottage cheese & whole eggs are allowable meat alternates

Ready-to-eat cereals are allowed at snack only for older infants.

Meal Patterns Previous vs Updated

Previous Age Groups

Birth - 3 months

4 -7 months

8 - 11 months

Updated Age Groups

Birth - 5 months

6 - 11 months

Encourages Breastfeeding

•Breastmilk is the optimal source of nutrients

•Birth through the end of 5 months

Breastmilk or infant formula is the only meal component required

Minimum serving size is 4 – 6 oz of breastmilk (or infant formula)

Promotes Developmental Readiness

• Delays the introduction of solid foods until around 6 months

• Most infants are not ready to consume solid foods until midway through the first year

• Introduction of solid foods too soon increases the risk of obesity

Allows More Nutritious Foods • Foods from all food components may be served around

6 months, when developmentally ready • Breakfast, Lunch, & Supper Breastmilk or iron-fortified infant formula Infant cereal, meat/meat alternates, or a

combination of both Vegetable or fruit, or a combination of both

• Snack Breastmilk or iron-fortified cereal Grains Vegetable or fruit, or a combination of both

Focuses on Serving Sizes

• Food components beginning with “zero”

Recognizes that all infants are not ready for solid foods at 6 months

• By 7 or 8 months, infants should be consuming solid foods from all food groups.

Focuses on Eating Habits

• Recognizes eating habits may change

Some infants may eat certain foods one week/day, but not the next

Meals & snacks consistent with eating habits should not be disallowed

Developmental Readiness

• Introducing solid foods too early: Causes choking

Consumes less breast milk or formula

• Serve solid foods when infants are developmentally ready

When Are They Ready?

• Sits in a chair with good head control

• Opens mouth for food

• Moves food from a spoon into throat

• Doubles in birth weight

According to the American Academy of Pediatrics (AAP) Developmental Readiness Guidelines

Providing Food Components

• Parents/guardians may provide only one creditable food component for a reimbursable meal i.e.; provide breastmilk = 1 component

• Child care providers must provide remaining components

Juice

• Lacks dietary fiber found in other forms of fruits & vegetables

• No longer credits toward a reimbursable meal for infants

Fluid Milk Component

One Year Olds

• Most 1 year olds need whole milk

Provides higher fat content

Promotes healthy growth & development

• Whole unflavored milk is required at breakfast, lunch, & supper

Optional at snack

• Serve 4 fl oz (1/2 cup) of unflavored whole milk

Breastmilk Past Age One

• May be served as a fluid milk to children of any age

• Reimbursable

If a parent/guardian provides expressed breastmilk

A mother breastfeeds her child on-site

• May be served in combination with other milk types for a reimbursable meal

i.e., mother brings ¼ cup for 1 year old, provider would supply ¼ cup whole unflavored milk for a total of ½ cup serving

Transition Period

• One-month transition period is allowable

Switch whole milk to low-fat or fat-free milk

• Children 24 months to 25 months may be served

Whole milk or reduced-fat (2%) milk

Two to Five Year Olds

• Serve unflavored low-fat (1%) milk or fat-free (skim) milk

• Minimum serving sizes

2 years – 4fl oz or ½ cup

3-5 years – 6 fl oz or ¾ cup

• Flavored milk is not reimbursable

6 year olds +

• Serve unflavored or low-fat (1%) milk or fat free (skim) milk

• Minimum serving size 8fl oz or 1 cup

• Flavored Milk Serve only fat-free flavored milk (best practice

recommendation – contain no more than 22 grams of sugar per 8 fluid ounces)

Milk Substitutions

• Allowed for non-disability medical or special dietary need

• Medical statement is not required if nutritionally equivalent to cow’s milk

• Request must be made in writing

• “Medical statement (CCM’s form) is required when a disability requires a non-dairy beverage that is not nutritionally equivalent to cow’s milk…”

Water • Drinking plenty of water is important

• Must be offered and made available throughout the day to children

• Mealtimes: Water is not a part of the reimbursable meal

May not be offered in the place of milk

May be offered alongside milk at meals

Meat/Meat Alternates • Breakfast: May be served

in place of the grain component for a maximum of 3 times per week

• Increases variety on the

menu • Allows more flexibility

when planning menus

Crediting Guideline

• Serving m/ma in place of grains:

1 oz of m/ma credits as 1 serving of grains

• Menu Example:

Cheese Omelet (Credits as the m/ma)

Fruit

Milk

Tofu

• Commercial tofu & soy yogurt to credit as a m/ma

• Does not credit toward reimbursable meals for infants

Using Tofu

• Forms: Silken, soft, firm, extra firm

• Commercially prepared tofu

Must be easily recognized as meat substitute

Must meet protein requirements

5 grams of protein per 2.2 ounces (1/4 cup) by weight

Non-Creditable Tofu

• Tofu such as soft or silken, used to add texture or enhance nutrients in foods

• Non-commercial & non-standardized tofu & soy products are not creditable

• WHY?

Not recognizable & safety concerns

Yogurt

• Yogurt must contain no more than 23 grams of total sugars per 6 oz….

Calculation

• Find sugar content

• Find serving size

• Divide serving into sugar

45 grams sugar

23 grams serving size

1.956 0.135 or less when grams 3.83 or less when ounces

NO

Using Yogurt

• Use commercial yogurt products only

• Soy yogurt is a dairy-free option. ½ cup (4.0 fluid oz) = 1.0 ounce equivalent meat alternate

• 4 oz credits as 1 oz of meat alternate

Non-Creditable Yogurt Products

• Frozen yogurt

• Drinkable yogurt

• Homemade yogurt

• Yogurt flavored products

• Yogurt bars

• Yogurt flavored fruits & nuts

• Yogurt in commercially prepared smoothies

Other Meat Alternates

• Nuts & seeds

• Dry beans and peas

• Eggs

• Cheese

Vegetables & Fruits

• Most children do not eat enough vegetables and fruits

• Often they are prepared with added salt, sugar, solid fat, and refined starch

• Separating vegetable and fruit components into two components

• Limits the service of juice to once per day

Separation of Vegetables & Fruits

• Breakfast: 1 food component

• Lunch & Supper: 2 food components

• Snack: Optional 2 food components

Increase Vegetable Consumption

• Lunch & Supper: A vegetable may be used to meet the entire fruit component

• Must be at least the same serving size as the fruit component that it replaced

Juice

• Lacks dietary fiber

• High sugar content

• Whole fruits energize the body more evenly

• MAY ONLY BE SERVED ONCE PER DAY

Grains

• At least one serving of grains per day must be whole-grain rich

• Breakfast cereals must contain no more than 6 grams of sugar per dry oz

• Grain-based desserts no longer credit toward the grain component

WHOLE GRAIN-RICH foods contain 100% whole grains, or at least 50% whole grain, & the remaining grains in the food are enriched

• Each day, at least one meal or snack must include a whole grain rich food

• If a facility only serves one meal per day, a whole grain-rich product must be served at that meal

• If more than one meal is served, the facility chooses which meal to serve the whole grain-rich food

Whole Grain-Rich Criteria

• Whole grains are the primary ingredient by weight Read the list of ingredients

Cracked wheat or crushed wheat, whole wheat flour, graham flour, bromated whole wheat flour, whole durum wheat flour

• Whole Grains Common & Usual Names Whole listed before grain, berries or groats, rolled oats &

oatmeal

• Food package lists a FDA approved whole-grain health claim

Non-Mixed Dishes

• Common examples: breads & cereals

• First ingredient is a whole grain and all other grains are enriched

• First ingredient is water & the second ingredient is a whole grain and all other grains are enriched

Multiple Grain Ingredients

• When a whole grain is not listed as the first ingredient for non-mixed dishes

• Whole grain-rich if combined weight of whole grains is more than the weight of the other grains

For example: a bread contains three grain ingredients

Enriched wheat flour (40% of grain weight)

Whole-wheat flour (30% of grain weight)

Whole oats (30% of grain weight)

Whole Grain Health Claim

• “Diets rich in whole grain foods & other plant foods and low in total fat, saturated fat, & cholesterol may reduce the risk of heart disease & some cancers.”

OR

• “Diets rich in whole grain foods & other plant foods, & low in saturated fat & cholesterol may help reduce the risk or heart disease.”

Whole Grain Stamps

Basic Stamp Does NOT meet whole

grain-rich criteria

100% MAY meet the whole grain-rich criteria, but needs additional documentation

Homemade Grain Products

• When making baked goods, you must have a copy of the recipe broken down to show that the whole grains are more than 50%

i.e., whole wheat flour – 2

cups

Enriched white flour – 1 cup

Menus & Whole Grain-Rich Foods

• DOCUMENT WHOLE GRAIN-RICH FOODS ON MENU

Examples:

Whole wheat bread

Whole grain-rich English muffins

Whole grain cracker

Whole grain- rich cracker

Whole grain tortilla

Brown rice

Oatmeal

Abbreviations are acceptable. “WGE bread”

Reviews Whole Grain-Rich Foods

• Review menus, labels & product information – providers must have labels, ingredient list on site for documentation at a visit.

• When a whole grain-rich food is not served: The meal or snack containing the grain with the lowest

reimbursement will be disallowed

i.e., no whole grain-rich food was served for breakfast, lunch or snack, so the snack would be disallowed

i.e., if a grain was served at breakfast and at lunch (and none at snack) and neither were whole grain-rich, the breakfast would be disallowed

Breakfast Cereals

• Source of added sugar

• Types: Ready-to-eat, instant, & regular hot cereal

• Must contain no more than 6 grams of total sugar per dry oz

Approved Breakfast Cereal

• Use WIC Approved Breakfast Cereals List

• Complete a Calculation

Use WIC Approved Breakfast Cereals Lists

• Choose breakfast cereal from ANY WIC Approved cereal list

Meets the sugar limits for CACFP

All WIC approved breakfast cereals contains no more than 6 grams of sugar per dry oz

Complete a Calculation

• Breakfast cereal must be within the threshold of 0.212 or less

• Steps

• Find the Nutrition Facts Label

• Find the Serving Size: 28 grams

• Find the amount for Sugars: 1 gram

Complete a Calculation (cont.)

• Calculate the amount of sugar

𝑆𝑢𝑔𝑎𝑟𝑠

𝑆𝑒𝑟𝑣𝑖𝑛𝑔 𝑆𝑖𝑧𝑒 =

1

28 = 0.036

• Threshold: 0.212 or less, the cereal is creditable

• Creditable: 0.036 is less than 0.212

Grain-Based Desserts

• Source of added sugars & saturated fats

Increases risk of chronic illnesses

• Not creditable towards the grain component

List of SOME Grain-Based Desserts

• Breakfast bars

• Brownies

• Cakes

• Cereal bars

• Cookies

• Doughnuts

• Granola bars

• Sweet piecrusts

• Sweet rolls

• Toaster pastries

Identification of G-B Desserts

• Some foods are not easily identified as grain-based dessert

i.e., a cookie is labeled “breakfast round”

• Ask the question:

Is this food thought of as a dessert?

G-B Desserts & Special Occasions

• Annual festival, birthday celebrations, end-of-year bash, or other special events

• May be served as an additional item only

Deep Fat Frying

• May not be used to prepare meals on-site

• Defined as food

submerged in hot oil or other fat

• Can be dangerous

• Too many deep-fat fried foods may contribute to chronic illnesses

Foods Fried Off-Site

• May purchase from commercial manufacturer

• Pre-fried

• Flash-fried

• Par-fried

• Deep-fat fried

• May not deep-fry when reheating

Providing Food Components

• Parent/guardian may provide only one creditable food component for a reimbursable meal for any age child

i.e.; provide special grain, organics, special brands, etc

• Child care providers must provide remaining components for the meal to be reimbursable

Reward & Punishment

• Negative effect on development & socialization

• Rewards may lead to cavities & weight gain

• Punishment may cause overeating

• Not allowed in CACFP facilities

Grace Period – 1 year

• Does this mean I have an entire year to start making the changes?

NO – You must implement all of the changes on October 1, 2017

• Well then, what does it mean?

• You won’t be penalized if you make honest mistakes

For example: what you thought was a whole-grain rich item turns out not to be, or you forgot one day to put one in

You made an error in your sugar calculations and the cereal or yogurt wasn’t credible

You served two fruits at a meal

Thank You

• We realize that this transition may be confusing at times and that you will have questions as time progresses.

• As always – Call or email us (786-0925 or 1-800-784-0157) cacfp@ccmaine.org

YOU ARE NOT BOTHERING US!

We are here to assist you.